Chapter 14 Before Conception

Ampulla:

The distal third of the fallopian tube, furthest from the uterus

Pregnancies __________________ years are considered high risk because of advanced maternal age and largely because of the higher potential for diminished egg quality and an increased risk for pregnancy-related complications as well as the greater likelihood of preexisting health conditions.

after age 34

cultural competence

the capacity to work effectively and with people, integrating elements of their culture-vocabulary, value, attitudes, rules, and norms. Translation of knowledge into action.

Cultural Sensitivity

understanding and accepting different cultural values, attitudes, and behaviors.

Follicle-stimulating hormone (FSH)

A hormone produced by the pituitary gland that, in women, regulates the menstrual cycle and recruitment of follicles by the ovaries

Corpus luteum

A hormone-secreting structure that forms from the follicle from which an egg has been released from the ovary

Medicaid

A joint state and federal program of healthcare insurance

Graafian follicle

A mature ovarian follicle from which the secondary oocyte will issue

Medicare Part C refers to

a system of private insurance providing the Medicare Part A and Part B coverage

Cultural Humility

a lifelong process of self-reflection and self-critique that begins, not with an assessment of a client's beliefs, but rather an assessment of your own.

Employers may elect to provide _____ coverage as part of their policies for employees, although the law does not require it.

abortion

Approximately _____% of children are living in a family with a stepsibling, half-sibling, and/or stepparent

16

_____% of children in the United States are being raised in a blended married family

22

Luteinizing hormone (LH)

A hormone originating in the anterior pituitary gland that triggers ovulation

Gonadotropin-releasing hormone (GnRH)

A hormone produced by the hypothalamus that, when secreted, triggers the pituitary gland to secrete the gonadotropin hormones, luteinizing hormone and follicle-stimulating hormone, which are involved in regulating the ovarian cycle

Advanced Maternal age

34+

Hook effect

A phenomenon by which the human chorionic gonadotropin level is so high that it causes a false negative pregnancy test result

Biochemical pregnancy

A pregnancy that ends shortly after implantation

Cortical reaction

A process by which the ovum prevents penetration from more than one sperm

Goodell's sign

A softening of the cervix that occurs in pregnancy

Hegar's sign

A softening of the isthmus of the uterus that occurs during pregnancy

Teratogen

A substance with the potential to harm a pregnancy

Medicare is broken into four categories:

A, B, C, and D.

Cultural Awareness

Being aware that we all live and function within a culture of our own and that our identity is shaped by it.

A woman has come to the clinic for her first prenatal visit. Which method would be the most effective way for the nurse to initiate data gathering for a health history? Ask her to complete a written questionnaire concerning her past and present status. Conduct an interview in a private room to obtain her health history. Wait until she is in the examining room and prepared for her physical examination. Ask her some basic questions in the waiting room before taking her to the examining room.

Conduct an interview in a private room to obtain her health history. Health interviewing is always conducted best in a quiet, private setting before examination procedures begin.

Medicaid Eligibility requirements

Determined at the federal level, but individual states may opt to extend coverage to people outside of the mandated federal minimum.

Medicare Eligibility requirements

Determined by age (65 y and over). People with certain disabilities who are not yet age 65 y are also covered, as are people with end-stage kidney disease.

A group of nursing students are preparing a presentation for a health fair illustrating what happens to the body during pregnancy. Which structure will the students point out is influenced the most by hormones to prepare for conception? myometrium endometrium perimetrium fundus

Endometrium The endometrium is the inner layer of the uterus; it builds with hormones during the month in potential preparation for pregnancy. The myometrium is the muscular layer. The perimetrium is a protective layer, and the fundus is the upper area of the uterus.

Arthralgia

Joint pain

The formation of fetal organs, or ________________, is a critical period of fetal development that occurs between 3 and 10 weeks of gestation.

Organogenesis

Fertilization

The fusion of egg and sperm

Amenorrhea:

The lack of menses

Zona pellucida

The layer of the ovum immediately below the corona radiata

Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome. True or False?

True

Luteinizing hormone is the hormone responsible for the release of the mature egg from the follicle. True or Flase?

True

Medicare Part A is

hospital insurance

insurance companies may no longer charge women more for coverage, and they are required to cover ___________________________________.

maternity and newborn care.

The Hyde Amendment,

prohibits spending federal spending on abortion, although individual states may elect to use state dollars to fund abortions for Medicaid patients.

Gametogenesis

The biologic process whereby cells undergo division to create gametes

Cohabitating-parent family

A family in which the parents are partners who live together but are not married

The nurse is conducting an initial history and assessment on a client at 10 weeks' gestation who is pregnant with her first child. Which question is a priority for the nurse to ask the client at this time? "Does anyone in your or the father's family have any genetic disorders?" "Do you plan to breastfeed or bottle feed your new baby?" "Are you planning to develop a birth plan for use during the birthing process?" "Was your mother or grandmother diagnosed with gestational diabetes?"

"Does anyone in your or the father's family have any genetic disorders?" Due to the timing of the client's pregnancy, it is a priority for the nurse to assess for potential risk factors for genetic abnormalities. The client is in the appropriate time frame to begin genetic testing if desired. The nurse will determine the client's feeding preference and plans to have a birth plan closer to birth to allow the client time to research these topics and make an informed decision about both. Gestational diabetes is not thought to be genetic in nature. The client will be tested for gestational diabetes regardless of family history during her second trimester.

Periodontal disease

A condition caused by bacterial infection of the structures around the teeth, including the gums, periodontal ligament, and alveolar bone

It is not necessary to seek early prenatal care if a woman is healthy. True or False?

False

Nuclear family

A family consisting of a married heterosexual couple and their children

The maternal mortality rate is _____ out of every 100,000 live births in the United States

14

The United States Census from 2014 showed that _____% of same-sex households included children.

17.3

Today, _____% of children live with only one parent, who is _____ times more likely to be a mother rather than a father

26 6

In the United States, the average maternal age at the time of the first birth is

26.3 years

As of 2013, approximately ______% of female same-sex couples and _____% of same-sex male couples in the United States were raising children

27 11

Organogenesis, the formation of fetal organs, occurs primarily between weeks _____ and _____ of gestation

3 10

_____% of single-mother families live in poverty. These mothers may report an increased susceptibility to _____ and to _____ and _____ social support

35 illness stress reduced

Approximately _____% to _____% of children were being raised without parents

4 5

A woman from Brazil and her husband are visiting the office for a prenatal checkup. Which of the following would be the best nursing intervention to show respect to the couple and their cultural and individual values related to childbirth? Ask the couple whether there is anything they believe should or should not be done to make the pregnancy successful. Explain to the couple how care for pregnancy has evolved from an illness approach to a view of pregnancy as healthy. Mention to the couple several examples of Brazilian birth practices that you have learned about online. Relate your own personal birth story to the couple.

Ask the couple whether there is anything they believe should or should not be done to make the pregnancy successful. To learn about the beliefs of a particular woman and her partner, ask at prenatal visits if there is anything the couple believes should or should not be done to make the pregnancy successful and keep the fetus healthy. Supporting these beliefs shows respect for the individuality of a woman and her knowledge of good health. The other answers do not allow the couple to speak of their cultural and individual values and therefore do not show respect to them.

Which information provided by a client would be considered a presumptive sign of pregnancy? Reports of increased hunger Weight gain Breast tenderness Ballottement

Breast tenderness Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable sign.

Menstrual cycle

Changes to the endometrium during the course of a woman's hormonal cycle

A girl comes from a large family that you analyze as being extended. In planning hospital care for her, which factor would be most important for you to consider? Spending increased time with her yourself to prevent loneliness. Organizing nursing care at times other than visiting hours. Restricting visitors to reduce the noise level. Asking the hospital's visitor program to call on her to prevent loneliness.

Organizing nursing care at times other than visiting hours. Because extended families have many members, support people in time of an illness are usually available. Restricting visitors will leave her without support and will be detrimental to her treatment. Asking the staff to visit will reduce her privacy. You as a practitioner cannot become personally involved.

Medicaid source of funding

State and federal funds

A nurse _____ _____ that an aspect of a culture is important to a patient simply because they identify with that culture.

cannot assume

Which body system is most affected throughout the embryonic and fetal period by teratogens? gastrointestinal system genitourinary system central nervous system musculoskeletal system

central nervous system Whether the teratogen is ingested, injected, occurs through an infectious agent, or is environmental, the CNS and brain are the body systems most seriously affected during this period.

Postnatally

Occurring after birth

The nurse is teaching an adolescent client about fertility and the various phases of the menstrual cycle. The client has a 28-day menstrual cycle. Which statement is a priority for the nurse to include in the teaching? "Days 1 through 5 are the days you will typically experience menstrual flow." "Day 10 is part of the proliferative phase of your menstrual cycle." "Day 14 of your menstrual cycle is normally when you will ovulate." "Days 27 and 28 are when you have declining hormonal secretions."

"Day 14 of your menstrual cycle is normally when you will ovulate." It is a priority for the nurse to teach the client when ovulation will occur to assist in pregnancy prevention at this age. While the other statements are all true, not knowing the specific information for those days does not hold the same consideration or life-altering potential as when pregnancy can occur. The menstrual cycle is based on an average of 28 days and divided into four phases based on the hormones secreted and their actions. Days 1 through 5 are the menstruation phase. Days 6 through 14 are the proliferative phase, ending with ovulation on the 14th day. Days 15 through 26 are the secretory phase. Days 27 and 28 are the ischemic phase when hormonal secretions decline.

How should the nurse document a pregnant client's gestational status using the GTPAL system after collecting the following data? Currently 18 weeks pregnantClient's fourth pregnancyDelivered one nonviable fetus at 26 weeksExperienced one miscarriageDelivered one viable fetus at 38 weeks' gestation 3, 2, 1, 2, 1 4, 2, 2, 1, 1 3, 2, 1, 1, 1 4, 1, 1, 1, 1

4, 1, 1, 1, 1 GTPAL is a more comprehensive system for classifying pregnancy status. By this system, the gravida classification remains the same, but para is broken down into T: the number of full-term infants born (infants born at 37 weeks or after), P: the number of preterm infants born (infants born before 37 weeks), A: the number of spontaneous miscarriages or therapeutic abortions, and L: the number of living children. The client has been pregnant four times. The client delivered one viable infant at 38 weeks. The client delivered one nonviable fetus at 26 weeks. The client had one miscarriage. The client has one living child.

_____% of babies born in the United States were born to women who are not married and were either single or in a partner relationship but unmarried

40

Higher costs are not associated with superior outcomes. In 2015, the infant mortality rate was _____ out of every 1,000 births in the United States

6

Chadwick's sign

A bluish discoloration of the female genitalia that is an early sign of pregnancy

Acrosome:

A cap on the head of the sperm that aids with the penetration of the ovum

Microcephaly

A congenital defect resulting from abnormal brain development in which the neonate's head is smaller than normal (Think of Micro= Small cephaly= head Therefore Small head)

Medicare

A federal program of healthcare insurance

Hypothalamic-pituitary-ovarian (HPO) axis

An endocrine feedback loop between the hypothalamus, anterior pituitary gland, and ovaries that regulates the ovarian cycle

Oocyte

An immature ovum cell

Good ________________ and having an open mind are essential for cultural competence.

Communication

Cultural Blindness

Do not see or believe there are cultural differences among people. Everyone is the same.

A pregnancy that is 37 0/7 weeks through 38 6/7 weeks is referred to as a(n) ________________ term pregnancy.

Early

What should the nurse include when counseling potential parents about genetic disorders? Environmental influences may affect multifactorial inheritance. Genetic disorders primarily follow Mendelian laws of inheritance. All genetic disorders involve a similar number of abnormal chromosomes. The absence of genetic disorders in both families eliminates the possibility of having a child with a genetic disorder.

Environmental influences may affect multifactorial inheritance. Not all genetic disorders follow Mendelian laws of inheritance. Diseases caused by multiple factors do not follow Mendelian laws because more than a single gene or HLA is involved. Environmental influences may be instrumental in determining whether the disorder is expressed. All genetic disorders do not involve a similar number of abnormal chromosomes. A family history may reveal no set pattern so an absence of genetic disorders in both families does not necessarily eliminate the possibility of having a child with a genetic disorder.

________________ is secreted by the ovaries after ovulation.

Estrogen

A school nurse who is teaching a health course at the local high school is presenting information on human development and sexuality. When talking about the role of hormones in sexual development, which hormone does the nurse teach the class is the most important for developing and maintaining the female reproductive organs? progesterone androgens follicle-stimulating hormone estrogen

Estrogen Estrogens are responsible for developing and maintaining the female reproductive organs. Progesterone is the most important hormone for conditioning the endometrium in preparation for implantation of the fertilized ovum. Androgens, secreted by the ovaries in small amounts, are involved in the early development of the follicle and affect the female libido. Follicle-stimulating hormone is responsible for stimulating the ovaries to secrete estrogen.

It is possible for ova to be fertilized up to 5 days after release into the fallopian tubes. True or False?

False

To be a culturally competent nurse, one must understand all aspects of a person's culture. True or False?

False

Extended family

Family beyond the nuclear family

Medicare source of funding

Federal funds

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Fetal movement felt by examiner Hegar sign Chadwick sign Positive office pregnancy test

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on a sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test has 95% accuracy; however, it may come back as a false positive. Hegar sign is a softening of the uterine isthmus. Chadwick sign may have other causes besides pregnancy.

Diploid

Having two sets of chromosomes, one from each parent

The nurse is assessing a 16-year-old female on a routine well-child visit. Which assessment finding will the nurse predict this healthy female will report concerning her menstrual cycles? Flow usually lasts 4 to 6 days. The usual cycle is 36 days. There's abundant clear mucus at the beginning Menstruation began at age 15.

Flow usually lasts 4 to 6 days. The average menstrual flow is 4 to 6 days in length. The cycle usually lasts 28 days. There should be no mucus during the menstrual cycle, with clear mucus being noted at the time of ovulation or approximately day 14. Menstruation usually begins at the age of 12 to 14 years.

The nurse is teaching a group of women about the hormone that makes the ovum within the ovaries mature each month. Which hormone is responsible for stimulating the ovum? Luteinizing hormone Estrogen Progesterone Follicle-stimulating hormone

Follicle-stimulating hormone The follicle-stimulating hormone (FSH) is the messenger from the pituitary gland to stimulate the ovum to mature. Luteinizing hormone is the hormone that is released from the pituitary gland once the follicle containing the ovum is mature, but it has no role in maturing the ovum. Estrogen and progesterone are integral parts of the ovulatory cycle but do not mature ovum.

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of spontaneous abortion (miscarriage) within the first trimester. The nurse is correct to document the history as: G = 4, T = 2, P = 0, A = 0, L = 1 G = 3, T = 1, P = 0, A = 1, L = 1 G = 1, T = 1, P = 1, A = 0, L = 1 G = 2, T = 0, P = 0, A = 0, L = 1

G = 3, T = 1, P = 0, A = 1, L = 1 The GTPAL stands for Gravida -- number of pregnancies, which is 3 (current, 4-year-old, and miscarriage); Term -- only one pregnancy thus far carried to term; Preterm deliveries -- 0; Abortions (either elective or miscarriage) -- 1; Living children -- 1. Do not be distracted by the twins. That is still one pregnancy.

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? G2 T2 P1 A0 L2 G2 T1 P1 A1 L1 G3 T0 P1 A1 L2 G3 T2 P2 A0 L1

G3 T0 P1 A1 L2 G indicates the total number of pregnancies (2 prior, now pregnant = 3); T indicates term deliveries at or beyond 38 weeks' gestation (none = 0); P is for preterm deliveries (at 20 to 37 weeks = 1; multiple fetus delivery are scored as 1); A is for abortions or pregnancies ending before 20 weeks' gestation (1); and L refers to living children which is 2. Thus, G3 T0 P1 A1 L2 is what the nurse should note in the client's record.

Haploid

Having one set of chromosomes

A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take? Contact the health care provider. Immediately stop the nurse. Call the client later and apologize. Tell the unlicensed assistive personnel

Immediately stop the nurse. The nurse should interrupt the nurse and remind him or her that it is important not to impose personal values onto the client.

Cultural destrutiveness

Making everyone fit the same cultural pattern and excluding those who don't fit-forced assimilation. Emphasis on differences as barriers.

Endometrial

Pertaining to the innermost layer or lining of the uterus, which is shed in part during menstruation

What are the probable signs of pregnancy that would be noted in a woman? Select all that apply. Visualization of the gestational sac Positive Goodell sign Ballottement Amenorrhea Breast tenderness

Positive Goodell sign Ballottement Probable signs of pregnancy include objective data such as the Goodell sign, which is cervical softening. Another probable sign is ballottement, which is when the examiner pushes against the uterine wall and it bounces back. Breast tenderness and amenorrhea are presumptive signs and visualization of the gestational sac is a positive sign of pregnancy.

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy? Fatigue Amenorrhea Positive home pregnancy test Nausea and vomiting

Positive home pregnancy test A urine pregnancy test is considered a probable sign of pregnancy as the hCG may be from another source other than pregnancy. Fatigue, amenorrhea, and vomiting are presumptive or possible signs of pregnancy and can also have other causes.

Amenorrhea is a(n) ________________ sign of pregnancy.

Presumptive

Oogenesis

The biologic process whereby cells undergo division to create ova

Spermatogenesis

The biologic process whereby cells undergo division to create sperm

Organogenesis

The biologic process whereby organs are created

Which statement best expresses the role of the corpus luteum? The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. The corpus luteum promotes the increased production of estrogen before ovulation. During the luteal phase, the corpus luteum secretes glycogen. Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum.

The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. The mature ovum is released from the ovary, resulting in the corpus luteum. Progesterone is produced by the corpus luteum. Estrogen is secreted by the ovaries. Glycogen is secreted by the endometrial glands during the luteal phase. Luteinizing hormone is not a product of the corpus luteum.

Infundibulum

The distal end of the fallopian tube, near the fibria

Corona radiata

The outermost portion of the ovum

Ovarian cycle

The phases of a woman's hormonal cycle specific to the ovaries, including the follicular phase, ovulation, and the luteal phase

Conception

The process of becoming pregnant

The nurse is reviewing the process of oocyte maturation and ovulation with a client. What occurs during the follicular phase of the ovarian cycle that the nurse should include in the teaching session? The uterus prepares for implantation of an ovum. The empty ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. About day 14, a surge of hormones cause the ovum to burst through the ovary. Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature.

Under the influence of follicle-stimulating hormone, several follicles begin to ripen, and the ovum with each begins to mature. The follicular phase lasts from about day 4 to about day 14. During this time, under the influence of follicle-stimulating hormone, several follicles begin to ripen and the ovum within each begins to mature. About day 14, a surge of hormones causes the ovum to burst through the ovary; this act is called ovulation. During the luteal phase, the empty, ruptured graafian follicle becomes the corpus luteum, and it begins to secrete progesterone and estrogen. The endometrium of the uterus has a similar cycle. It is called the uterine cycle or endometrial cycle. This process prepares the uterus for implantation of an ovum (egg).

The nurse is explaining the phases of the uterine cycle to a client. What action during the proliferative phase of the uterine cycle should the nurse include in the teaching session with the client? If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. An ovum matures and is released.

While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth. While the ovarian follicles are producing increased amounts of estrogen, the endometrium prepares for possible fertilization with pronounced growth during the proliferative phase. If fertilization does not occur, the corpus luteum degenerates, and hormonal levels fall during the secretory phase. Withdrawal of hormones causes the endometrial cells to change, and menstruation begins. Maturation of an ovum occurs during the ovarian cycle; growth of the lining (endometrium) of the uterus occurs during the uterine cycle. Together, these cycles are known as the menstrual cycle.

Capacitation

a biochemical change in the sperm that allows penetration into the egg and increased sperm mobility

Autosomes

a chromosome that is not a sex chromosome

What does the genetic analysis always include? assessment for any other potentially inherited condition interventions for other potentially inherited conditions evaluation of other potentially inherited conditions planning for other potentially inherited conditions

assessment for any other potentially inherited condition The genetic analysis always includes assessment for any other potentially inherited conditions for which testing, prevention, and treatment may be possible. Interventions are not carried out for potential genetic conditions. Evaluation and planning cannot be accomplished if the client does not have the disease.

thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. breast changes ultrasound pictures fetal heartbeat amenorrhea hydatidiform mole morning sickness

breast changes amenorrhea morning sickness Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)

A group of nursing students are comparing male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure? vulva clitoris vagina labia majora

clitoris The female clitoris is complementary (equitable) to the glans; both of these are composed of erectile tissue and are the primary organs responsible for orgasm. Other comparable structures include the testes and ovaries, and scrotum and labia majora. The vagina does not have a comparable male structure.

The nursing instructor is preparing a class presentation covering the various hormones and their functions during pregnancy. The instructor determines the class is successful when the class correctly matches which function with hCG? maintains nutrient-rich decidua sustains life of placenta continues progesterone production by corpus luteum provides rich blood supply to decidua

continues progesterone production by corpus luteum The corpus luteum is responsible for producing progesterone until this function is assumed by the placenta. hCG is a fail-safe mechanism to prolong the life of the corpus luteum and ensure progesterone production. Estrogen is responsible for providing a rich blood supply to the decidua. Progesterone helps maintain a nutrient-rich decidua.

Insurers are also obligated to pay for_____ _____ and methods for women without a co-pay, even if a woman has not met her insurance deductible.

contraceptive counseling

While conducting the first prenatal health history visit, the nurse learns that a pregnant client is taking various herbal remedies and over-the-counter medications for minor ailments. Which nursing diagnosis should the nurse identify as being appropriate for the client at this time? health-seeking behaviors related to guidelines for nutrition and activity during pregnancy risk for injury to fetus related to lifestyle choices health-seeking behaviors related to strong cultural desire to have a healthy child deficient knowledge regarding exposure to teratogens during pregnancy

deficient knowledge regarding exposure to teratogens during pregnancy The client is taking herbal remedies and over-the-counter medications, many of which can be teratogenic to the developing fetus. This is the most appropriate nursing diagnosis for the nurse to select for this assessment finding. There is not enough information to determine if the fetus is at risk because of the client's lifestyle choices. The client has not asked for specific information so health-seeking behavior diagnoses would not be appropriate for the client at this time.

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: detect fetal heart sounds with a Doppler. feel fetal movements. hear the fetal heartbeat with a stethoscope. palpate the fetal outline.

detect fetal heart sounds with a Doppler. Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot be heard through a stethoscope until 18 to 20 weeks' gestation. Fetal movements can be felt by a woman as early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is also palpable around 20 weeks' gestation.

When caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge, you: document her report but do nothing, as this is a cultural belief that should be respected. discuss how painful this will be once the baby has teeth. advise her to be careful who she discusses this with, as many will consider that a type of reportable child abuse. encourage her to start the baby on formula after the first year as recommended by many physicians.

document her report but do nothing, as this is a cultural belief that should be respected. Culturally specific decisions should be respected and incorporated into the plan of care. Options other than following the mother's wishes (insomuch as these wishes do not put the child in danger), are inconsequential and may be viewed as intrusive and inappropriate.

Same-sex couples are approximately _____ times as likely to be raising an adopted child and they are six times more likely than heterosexual parents to be raising foster children

four

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives? hepatitis B measles mumps rubella

hepatitis B Hepatitis B vaccine should be considered during pregnancy. Immunizations for measles, mumps, and rubella are contraindicated during pregnancy.

To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, which of the following would you ask? his mother's occupation his mother's attitude toward citizenship the adolescent's education level his family structure

his family structure Family structure is a characteristic strongly influenced by culture. The mother's occupation and citizenship do not affect the treatment of the adolescent client. The client's education also should not be a factor in treatment.

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? sexual development of the client whether sex was consensual options for birth control in the future knowledge of child development

knowledge of child development The nurse should address the client's knowledge of child development during assessment of the pregnant adolescent client. The nurse need not address the sexual development of the client or whether sex was consensual. This would not be an opportune time to discuss birth control methods to be used after the pregnancy.

Medicare Part B is

medical insurance

Women who are obese in pregnancy are at higher risk for developing all of the following except: macrosomia pregnancy-induced hypertension gestational diabetes neural tube defects cesarean birth.

neural tube defects Folic acid deficiency will increase the risk of neural tube defects.

Medicare Part D is

prescription drug coverage.

A nurse is preparing a teaching plan for a woman who is planning to become pregnant. Which hormone secreted by the corpus luteum would the nurse include in the discussion when describing how the endometrium is prepped for egg implantation? testosterone progesterone prolactin luteinizing hormone

progesterone After the follicle ruptures as it releases the egg, it closes and forms a corpus luteum. The corpus luteum secretes increasing amounts of progesterone and estrogen, which interact with the endometrium to prepare it for implantation. The corpus luteum does not secrete prolactin, testosterone, or luteinizing hormone.

cultural competence is about

recognizing and respecting a person's culture and integrating the aspects important to that individual into their care

After teaching a class on the female reproductive system, the nurse determines that the teaching was successful when the class identifies which action as the primary function of the ovaries? carrying the ovum to the endometrium secreting estrogen and progesterone secreting mucus that supplies lubrication for intercourse implanting a fertilized ovum

secreting estrogen and progesterone The ovaries have two primary functions: development and release of the ovum and secretion of estrogen and progesterone. The fallopian tubes are responsible for conveying the ovum from the ovary to the uterus and sperm from the uterus toward the ovary. The Bartholin glands when stimulated secrete mucus that supplies lubrication for intercourse. The uterus is the site of implantation of a fertilized ovum.

An adult client currently has low levels of estrogen and progesterone. At this point in the menstrual cycle, the client will likely: shed her uterine lining. ovulate. become pregnant. experience endometrial regeneration.

shed her uterine lining. Low levels of estrogen and progesterone cause the shedding of the uterine lining (endometrium). Ovulation and subsequent pregnancy result from increased hormone levels. Regeneration follows ovulation during the secretory phase.

Which vaccine is safe to give in pregnancy? the flu vaccine after the first trimester the measles vaccine in the second trimester the varicella vaccine before 36 weeks the HPV vaccine if the woman is younger than 26 years of age

the flu vaccine after the first trimester Live viruses vaccines such as MMR, varicella, and HPV are contraindicated in pregnancy.